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Research Article Free access | 10.1172/JCI113416

Paradoxical glottic narrowing in patients with severe obstructive sleep apnea.

I Rubinstein, A S Slutsky, N Zamel, and V Hoffstein

Department of Medicine, St. Michael's Hospital, Ontario, Canada.

Find articles by Rubinstein, I. in: PubMed | Google Scholar

Department of Medicine, St. Michael's Hospital, Ontario, Canada.

Find articles by Slutsky, A. in: PubMed | Google Scholar

Department of Medicine, St. Michael's Hospital, Ontario, Canada.

Find articles by Zamel, N. in: PubMed | Google Scholar

Department of Medicine, St. Michael's Hospital, Ontario, Canada.

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Published April 1, 1988 - More info

Published in Volume 81, Issue 4 on April 1, 1988
J Clin Invest. 1988;81(4):1051–1055. https://doi.org/10.1172/JCI113416.
© 1988 The American Society for Clinical Investigation
Published April 1, 1988 - Version history
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Abstract

Most patients with obstructive sleep apnea have increased pharyngeal collapsibility (defined in the present study as an increased lung volume dependence of pharyngeal area), which predisposes them to upper airway occlusion during sleep. However, there are patients with severe obstructive sleep apnea who have low-normal pharyngeal collapsibility. The factors leading to nocturnal upper airway obstruction in such patients have not been ascertained. We studied 10 overweight male patients with severe obstructive sleep apnea and low-normal pharyngeal collapsibility to determine the site of upper airway pathology in these patients. We found that all 10 patients exhibited paradoxical inspiratory narrowing of the glottis during quiet tidal breathing. This phenomenon was not observed in a matched group of 10 snoring, nonapneic male controls. We conclude that paradoxical glottic narrowing may be a contributing factor in the pathogenesis of upper airway obstruction in patients with severe obstructive sleep apnea who have low-normal pharyngeal collapsibility.

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